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Found 19 results
  1. Content Article
    People living in deprived areas experience the most significant health inequalities in terms of access, experience and outcomes. There are large reductions in life expectancy for those living in the most deprived areas compared to people living in the least deprived areas. NHS England commissioned a research project into access, experience and outcomes related to health services in socio-economically deprived communities. This communications and engagement toolkit is an output of the research. The toolkit is designed to be used by communications and engagement professionals and others across the NHS with a responsibility for communicating to and engaging with people in the most deprived areas.  This toolkit provides: Information on who lives in the most deprived areas – for example by age, ethnicity and education. General principles to consider when developing communications and engagement materials for people living in deprived areas. Guidance to use when communicating about specific services – for example accessing GPs or mental health services. Considerations regarding opportunities to use communications to improve interactions between healthcare professionals and patients living in deprived areas. A communications and engagement checklist to use when developing materials. It is not necessary to read the whole toolkit. You can access what is most relevant to you. Click the boxes at the top of each slide to navigate to the sections that are useful to you. Click the ‘home’ icon in the top right of the page to return to the start and select a new topic.
  2. Content Article
    In a multicultural society, individuals from diverse linguistic backgrounds may face language barriers when seeking healthcare. Effective communication is essential to ensure that patients can accurately express their symptoms, concerns and medical history, and understand the information given to them by healthcare providers. In this blog, Kathryn Alevizos discusses some of the common language barriers non-native English speaking patients can experience, and offers practical advice on how we can all improve our intercultural communication skills. Why is inclusive intercultural communication important in healthcare? Effective communication between healthcare providers and non-native English speaking patients is essential for accurate diagnosis and treatment. Of course, communication also plays a significant role in patient safety. Clear and concise communication among healthcare team members helps prevent errors, such as medication mix-ups or misinterpretation of instructions. In addition, communication helps build trust and rapport between healthcare providers and patients. When patients feel heard, understood and respected, they are more likely to actively participate in their own care and follow treatment plans. What steps can we take to make our language easier to understand? There are many ways we can adjust our language, but below are four good starting points: 1. Add pauses when you speak Slow down and, more importantly, add pauses when you’re speaking so that your patient has time to process what you’re saying. If English is not your patient’s first language, it may take them longer to digest what is being said, work out their response and then find the right words in English to reply. Although we often feel uncomfortable with silences in our conversation, these pauses can be critical to a patient’s understanding. Adding pauses also supports active listening and will help you respond appropriately to your patient’s language level. On a final point, including pauses can make your accent easier to understand. 2. Reduce idiomatic language and paraphrase when necessary There are approximately 25,000 idioms in the English language! This is why we have to be mindful when we use them with non-native English speaking patients as it’s impossible to know which ones they will know. Expressions such as ‘nip it in the bud’, ‘bear with me’ and ‘feeling out of sorts’ can leave your patient confused, adding to any potential stress. It’s unrealistic to stop using idiomatic language completely but try to paraphrase where possible; for example, I hear you’re a bit under the weather, feeling unwell. 3. Avoid (or at least explain) acronyms and abbreviations Healthcare is full of specialist terminology and acronyms. These are particularly difficult for patients who speak English as an additional language. Even everyday terms such as ‘GP’ and ‘A&E’ may be unfamiliar as well as non-medical acronyms such as ASAP. The fact that certain letters can sound very similar, for example ‘p’ and ‘b’ or ‘f’ and ‘s’, compounds the problem. So when you use them for the first time, explain what you mean. If there are numerous terms associated with a particular health condition or treatment, consider giving your patient a written glossary of terms. 4. Use direct questions The language we use is often very indirect and this is particularly true of how we structure questions and instructions. We instinctively add unnecessary language in order to ‘soften’ our request or to come across as friendly and polite. For example, we may say "I was wondering whether we could have a quick chat about your medication?" rather than the much more straightforward "Could we talk about your medication?" It’s important to keep questions short, simple and direct. You can create a friendly manner through facial expressions and using your patient’s name. Call for action Awareness of how we can all adapt our language to better meet patient’s needs is key. While health organisations regularly make use of translators and interpreters, many are unaware of the intercultural communication training that members of staff can take part in to support and enhance their communication skills. By making health organisations more language aware, staff can start to implement simple strategies that will improve patient safety and optimise their healthcare experience. Related reading on the hub: Accessible patient information: a key element of informed consent (by Julie Smith) CardMedic: Empowering staff and patients to communicate across any barrier
  3. News Article
    Leeds Teaching Hospitals has launched a support fund for patients, their relatives and volunteers who may be struggling financially due to the coronavirus pandemic. The fund is intended to assist (but is not limited to): Bereaved relatives facing immediate financial pressures until their personal financial affairs are sorted eg having weekly bills to meet and no immediate access to bank accounts Patients isolating for 14 days in advance of admission to hospital and suffering income loss, excess cost or other financial hardship as a result Patients, their immediate families or volunteers who have experienced significant household income loss as a result of the pandemic and are struggling with financial obligations Those experiencing significant increases in costs as a direct result of the pandemic, eg increased childcare costs Read the full article here
  4. Content Article
    This article from the King's Fund examines the differences in health outcomes for ethnic minority groups, highlighting the variation across groups and conditions, and considers what’s needed to reduce health inequalities.
  5. Content Article
    This is the report of the Scottish Government's Ministerial Task Force on Health Inequalities. The report brings together thinking on poverty, lack of employment, children's lives and support for families and physical and social environments, as well as on health and wellbeing. It makes clear that the Scottish Government will not only respond to the consequences of health inequalities, but also tackle its causes.
  6. Content Article
    In a project led by the Race Equality Foundation, the Men’s Health Forum teamed up with Faith Action and Clinks to develop a community-centred programme to offer blood pressure testing and raise awareness amongst black African and Caribbean males. The programme was piloted in barbershops, a bus depot and a local church in three London boroughs. It demonstrated that offering blood pressure checks in community settings could help overcome the reluctance amongst black African and Caribbean men to have their blood pressure checked. The report, following evaluation between February-March 2020 in the London boroughs of Southwark, Hackney and Brent, concluded: 'The community blood pressure programme was welcomed in all community settings. The pilots engaged a considerable number of men in an accessible environment that they were comfortable in. There was a willingness from community stakeholders for the programme to be implemented over a longer period of time, and healthcare providers may wish to consider the practicalities of delivering blood pressure testing in similar settings for specific target groups.'
  7. News Article
    Leading doctors say they have concerns about the NHS reducing mentions of the word "women" in ovarian cancer guidance. They say "it may cause confusion" and create barriers to care. But NHS Digital, which writes the online advice, said they wanted to make it relevant for everyone who needs it. The updated guidance now says that people with ovaries, such as trans men, can also be affected. Until February, the NHS guidance began by explaining ovarian cancer was "one of the most common types of cancer for women". Now, the only specific mention of women comes on the third page with the explanation that ovarian cancer can affect "women, trans men, non-binary people and intersex people with ovaries". NHS Digital said the changes were introduced to make the advice more relevant and inclusive. The Royal College of Obstetricians and Gynaecologists, which represents thousands of women's health specialists and pregnancy doctors, said the language used "does need to be appropriate, inclusive and sensitive to the needs of individuals whose gender identity does not align with the sex they were assigned at birth". But it added: "Limiting the term 'woman' to one mention may cause confusion and create further barriers for some women and people trying to make an informed choice about their care. "We would therefore support the use of the word 'woman' alongside inclusive language." Read full story Source: BBC News, 8 June 2022
  8. Content Article
    In October 2021 the government announced a review into leadership across health and social care, led by former Vice Chief of the Defence Staff General Sir Gordon Messenger and supported by Dame Linda Pollard, Chair of Leeds Teaching Hospital Trust. The results of the review have now been published and recommendations made. The 'Leadership for a collaborative and inclusive future' review (also know as the 'Messenger review', led Sir Gordon Messenger and supported by Dame Linda Pollard, focused on the best ways to strengthen leadership and management across health and with its key interfaces with adult social care in England. Findings Cultures and behaviours The review found that the current cultural environment does not lend itself to the collaborative leadership needed to deliver health and social care in a changing and diverse environment. Leadership is seen as a job role rather than a characteristic that runs through the workforce. Staff respond reactively rather than constructively and respond to high levels of pressure from above. There is also a lack of accountability and authority in some areas. Although not universal, acceptance of discrimination, bullying, blame cultures and responsibility avoidance has almost become normalised in certain parts of the system. Equality, diversity and inclusion (EDI), which is about respectful relationships and underpins a wider culture of respect, is partial, inconsistent and elective. In some places it is tokenistic. There is a lack of psychological safety to speak up and listen, despite progress being made. The Freedom to Speak Up initiative can be perceived as just relating to whistleblowing rather than also organisational improvement. Standards and structures The review found that management tend not to be perceived as a professional activity and there is a lack of universal standards for management competence and behaviour. There are inequities in how managers are perceived, valued and trained and inconsistencies in appraisals. Regulation and oversight There is a positive view that the Care Quality Commission (CQC) can influence collaboration across the whole of health and social care through its inspections, and welcome its increasing focus on teams and systems. However, there is sometimes an over-emphasis on metrics which can be counter-productive. The review welcomes the shift in emphasis from a punitive model to a remedial one. Clinical leadership The review found incidences of the flawed assumption that simply acquiring seniority in a particular profession translates into leadership skills and knowledge. Doctors are often not properly trained or equipped for leadership roles. Allied health professionals often highlighted that they felt their career opportunities in management were limited. Management and leadership training should be an integral part of all clinical training pathways. Leadership delivery in the future The move towards health and care integration and the work currently underway to merge the arms-length bodies and create a new NHSE offers the opportunity for a fresh approach to preparing leaders and managers in the future. Recommendations 1. Targeted interventions on collaborative leadership and organisational values A new, national entry-level induction for all who join health and social care. A new, national mid-career programme for managers across health and social care. 2. Positive equality, diversity and inclusion (EDI) action Embed inclusive leadership practice as the responsibility of all leaders. Commit to promoting equal opportunity and fairness standards. More stringently enforce existing measures to improve equal opportunities and fairness. Enhance CQC role in ensuring improvement in EDI outcomes. 3. Consistent management standards delivered through accredited training A single set of unified, core leadership and management standards for managers. Training and development bundles to meet these standards. 4. A simplified, standard appraisal system for the NHS A more effective, consistent and behaviour-based appraisal system, of value to both the individual and the system. 5. A new career and talent management function for managers Creation of a new career and talent management function at regional level, which oversees and provides structure to NHS management careers. 6. Effective recruitment and development of non-executive directors (NEDs) Establishment of an expanded, specialist non-executive talent and appointments team. 7. Encouraging top talent into challenged parts of the system Improve the package of support and incentives in place to enable the best leaders and managers to take on some of the most difficult roles. All 7 recommendations have been accepted by the government and publication of the report will be followed by a plan committing to implementing the recommendations.
  9. Content Article
    Much research has been done into the causes, extent and impact of health inequalities that affect rural and coastal populations. Health services in these areas currently face serious challenges due to a combination of factors, including social deprivation, ageing populations and workforce staffing issues. In this blog, Patrick Mitchell, Director of Innovation, Digital and Transformation at Health Education England (HEE), describes a new HEE programme that aims to help tackle health inequalities in rural and coastal areas.
  10. Content Article
    In this article in the journal Public Health, Göran Dahlgren and Margaret Whitehead, the original authors of the Dahlgren and Whitehead model of the main determinants of health, sometimes known as ‘The Rainbow Model', reflect on how the model has been used over the past thirty years. They tell the story of the model’s journey from initial rejection to worldwide acclaim, and reflect on why it has proved illuminating in many different settings. The authors also outline how they use the model with the complementary Diderichsen Framework to explain the how the known determinants of health bring about health inequalities. They then discuss what else needs to be done to gain insight and take action on determinants of health and growing inequalities in the post-pandemic world.
  11. Content Article
    This white paper from the Institute for Healthcare Improvement (IHI) describes a framework to guide health care organisations in their efforts to provide safe, equitable, person-centred telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
  12. Content Article
    In a fundamental sense, the vision for transforming virtual care from that of an exclusive service that benefits only a few to that of a standard for providing equitable care for all echoes the age-old debate between policy variations on the zip code and the genetic code. This commentary from Esha Ray Chaudhuri aims to further develop the key theme of engaging the “reimagining” of virtual care for older ethnic adults—by considering the syndemic nature of COVID-19 and the intersection of cultural interventions in care and equity in virtual care.
  13. News Article
    In the older European population, men, as well as those with lower socioeconomic status, weak social ties, and poor health, might experience more difficulties getting informal support and are considered to have a higher risk of worsening frailty state and lower quality of life. This reality is shown in a new doctoral thesis at Umeå university. Read the full article here
  14. Content Article
    Many asylum seekers struggle to access healthcare when they come to the UK due to the extensive paperwork needed to register with primary care and other services. Many new arrivals have complex health needs for which current NHS healthcare systems struggle to offer appropriate care, exacerbating the trauma already experienced by many of these vulnerable people and families. In this article for The BMJ, the authors look at how how a model response to this issue was developed during the Covid-19 pandemic.
  15. Content Article
    Access to healthcare is a basic right, but refugees and people seeking asylum in the UK often face barriers to accessing health services. The Refugee Council has released this collection of guides and films for health professionals, decision-makers and NGOs to address health inequalities experienced by refugees and people seeking asylum. Resources and guides for healthcare professionals and policy-makers Refugee Council’s policy note on health barriers - outlines the main issues refugees and people seeking asylum experience when they access health services. Therapeutic IAHC Communication Card - a double-sided card with useful vocabulary and phrases with translations. It can be used to speed up and clarify communication about health problems with healthcare professionals, people who work in supporting organisations and members of the public. It has been translated into five languages: Albanian, Arabic, Dari, Farsi, Tigrinya. Maternity guide for women on asylum support Maternity guide for professionals These films are based on the Refugee Council's experience delivering the Health Access for Refugees Project (HARP): It is different over here: access to healthcare in the UK Experiencing the asylum process in the UK and impact on health Access to health for people seeking protection in the UK The right to be understood: the importance of interpreting Experts by Experience
  16. Content Article
    The Global Drug Policy Index provides a score and ranking for each country to show how much their drug policies and their implementation align with the UN principles of human rights, health and development. It offers an important accountability and evaluation mechanism in the field of drug policy. The Global Drug Policy Index measures how drug policies align with many of the key UN recommendations on how to design and implement drug policies in accordance with the United Nations principles of health, human rights, and development. The Index is composed of 75 indicators that run across five dimensions: The absence of extreme sentencing and responses to drugs, such as the death penalty The proportionality of criminal justice responses to drugs Funding, availability, and coverage of harm reduction interventions Availability of international controlled substances for pain relief Development The UK scores relatively low on 'Proportionality and Criminal Justice' and there is a need to reflect on this at a policy level. Read testimonies of people who have been directly affected by drug policies in the 30 countries covered by the Global Drug Policy Index.
  17. News Article
    NHS England will ask GP practices to make ‘reasonable adjustments’ for patients with a learning disability or autism such as giving them ‘priority appointments’. They could also be asked to provide ‘easy-read appointment letters’ to the group, the Department of Health and Social Care (DHSC) said yesterday in a new strategy on strengthening support for autistic people and those with a learning disability. It said the measures aim to support Government plans to reduce reliance on mental health inpatient care, with a target to reduce the number of those with a learning disability or autism in specialist inpatient care by 50% by March 2024 compared with March 2015. The policy paper said: ‘We know that people experience challenges accessing reasonably adjusted support which may prevent them from having their needs met.’ It added: ‘To make it easier for people with a learning disability and autistic people to use health services, there is work underway in NHS England to make sure that staff in health settings know if they need to make reasonable adjustments for people." NHS England is also developing a ‘reasonable adjustments digital flag’ that will signal that a patient may need reasonable adjustments on their health record, it said. It plans to make this flag, which is currently being tested, available across all NHS services, it added. Read full story Source: Pulse 15 July 2022
  18. Content Article
    In this blog for the King's Fund, Toby Lewis examines the need for NHS organisations to ensure its staff members in lower-paid roles are paid enough to meet their living costs. He calls for organisations to pay the real Living Wage, a figure based on actual living costs, rather than the National Living Wage. Currently, NHS pay scales at and below Band 2 spine point 3 do not reach the real Living Wage. He argues that adopting a real Living Wage policy results in a return on investment in the form of fewer vacancies, smaller staff turnover and less sickness - 60% of real Living Wage employers state that it improves recruitment, quality of applicant, and retention in lower-paid roles.
  19. Content Article
    Sunday 16 January 2022 marked World Religion Day. Around half of the UK population identify with a faith tradition, and in this blog, Jeremy Simmons, Policy and Programme Officer at FaithAction, highlights the important role of faith-based organisations in addressing health inequalities and helping people access healthcare. FaithAction is a national network of faith-based and community organisations seeking to serve their communities through social action and by offering services such as health and social care, childcare, housing and welfare to work. A few months ago, a friend of mine began to experience some worrying symptoms; he was diagnosed by his GP with anxiety and depression, and prescribed antidepressants. Like around half of the UK population,[1] my friend identifies with a faith tradition, and when he felt hesitant about taking the medication he’d been prescribed, his first port of call was to talk to a faith leader he trusted, who listened to his concerns and encouraged him to pursue the treatment he had been prescribed by his doctor. My friend did feel able to begin his treatment, and is doing much better. Supporting people through treatment is just one of the ways that faith communities facilitate patient safety. Here are three reasons why faith groups play an important role in the health of their communities: 1. Faith can reach to the heart of communities who struggle to access services I was at a meeting last year where an NHS director said he thought the rollout of the Covid-19 vaccine would not have been such a success were it not for the involvement of faith groups. Why? The willingness of so many mosques, churches, gurudwaras and temples countrywide to support messaging and open their doors as vaccine centres, meant healthcare crossed from the domain of waiting rooms and blue scrubs into spaces of commitment, familiarity and trust. People were able to begin having conversations about the efficacy and safety of vaccines in spaces that felt safe to them. The vaccine rollout is an example of just one area in which faith groups have been employed as trusted messengers within communities. The reality is, there are population groups in England who, for one reason or another, are insulated from much health messaging. It’s not that they are ignoring or misunderstanding the messages, they are simply not getting them. To give just one example, a faith organisation I know runs a befriending scheme in a deprived part of East London. I was talking to one of the organisers last October and she told me that she had just been explaining how to take a lateral flow test to a local couple. It was the first time this couple had seen or heard of these tests. For whatever reason, they hadn’t been able to access government and NHS messaging about rapid testing - but they had accessed this faith-based support group, and that made the difference. It is often said that no one is “hard to reach”, we just aren’t finding the right ways to reach them. Given the success of using faith centres in the Covid-19 vaccine rollout, what would be the potential in forging partnerships around such things as cancer screening or pregnancy and antenatal care, areas where huge health inequalities persist? 2. There is a link between faith groups and health inequalities Whilst it may be difficult to say a lot about the health inequalities that people of faith experience (very little data is routinely collected around faith and health) there are clues that indicate a link between faith and health outcomes. For example, the correlation between poverty and health inequality is well documented, and, after accounting for ethnicity, certain religions are at higher risk of experiencing poverty.[2] Just under half (46%) of the Muslim population, for example, live in the 10% most deprived, and 1.7% in the least deprived, Local Authority Districts in England.[3] Sikhs are also shown to be at greater risk of poverty than people from other faith traditions.[4] The pandemic has highlighted these trends, with ONS data demonstrating disproportionality in Covid-19 outcomes not just according to ethnicity but also faith, in part owing to socio-economic factors.[5] What can we conclude? If there are meaningful links between faith and inequality, then part of the way to tackle inequality must surely be to involve faith organisations. Faith organisations’ assets for health promotion (things like space, transport, time and willing volunteers) mean they are ideal places to run interventions and be involved in prevention initiatives. As we’ve seen, where this approach has been adopted in the pandemic it has been effective, suggesting the potential for more targeted work going forward. 3. Faith groups are often ‘first in and last out’ at the point of need Last year I was involved in surveying over 100 FaithAction members to build a picture of what work they had been doing in support of the NHS during the pandemic. I expected to discover a long list of activities (my conversations with faith groups this past year has left me in no doubt that they have been very busy). What I wasn’t expecting was that much of this activity was already well underway even before the pandemic hit. To give a few examples, over a third of the organisations surveyed were already helping patients with telephone or digital consultations before the pandemic. Just over 32% were already helping people make contact with health and care organisations, and 36% were providing transport to and from appointments. What this indicates is that when GP consultations became primarily digital in April 2020 these charities were already poised to help their beneficiaries connect. The survey also revealed faith groups delivering food and medication, offering support with mental health, supplying PPE and tackling misinformation. That faith-based organisations are “first in and last out” where need arises is a bit of a catchphrase at FaithAction. And yet it rings true, never more so than during the pandemic. We’ve witnessed faith-based organisations up and down the country respond with characteristic compassion, agility and innovation. And they continue to respond, even against a backdrop of funding shortages, limited resources and disruptions to normal activity and worship practices. You could say that the role of faith-based organisations during the pandemic has been something of a microcosm for the kind of cross-sector partnerships that might be built across the wider health and care landscape looking ahead. I think it shows the potential for a kind of creative thinking that seeks to strengthen partnerships across sectors for the benefit of our diverse communities. References 1 J Curtice, E Clery, J Perry et al. British Social Attitudes: The 36th Report. The National Centre for Social Research, 2019 2 M Marmot, J Allen, P Goldblatt et al. Fair Society, Healthy Lives – The Marmot Review: Strategic review of health inequalities in England post-2010. Institute of Health Equity, 2010;p38 3 Beckford, J. Review of the Evidence Base on Faith Communities. Office of the Deputy Prime Minister, 2006. Accessed 25 June 2021 4 Reducing poverty in the UK: A collection of evidence reviews. Joseph Rowntree Foundation, 2014. Accessed 25 June 2021 5 Rates of deaths involving COVID-19 by religious group, England and Wales. Office for National Statistics website. Last accessed 18 January 2022
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